# HEARTFUL ROOTS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932781234
- **Authorized official:** JESSICA GERSHWIN MSW, LCSW (LICENSED CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (802) 222-0885

## Contact information

- **Practice address:** 278 VANCE RD, DANVILLE, VT 05828-9465
- **Practice address phone:** (802) 222-0885
- **Mailing address:** 278 VANCE RD, DANVILLE, VT 05828-9465
- **Mailing address phone:** (720) 220-7525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 04/26/2021
- **Last updated:** 04/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 6703410 | — | VT |